Dr. Ashe has been prescribing GLP-1 medications for several years. As a board certified ER Physician, she has the knowledge and background to help guide you on your weight loss journey. She prescribes both Semaglutide (which you may know as Ozempic or Wegovy) and Tirzepatide (known as name brand Zepbound and Mounjaro). Dr. Ashe will determine which GLP-1 is the right choice for you after a detailed consultation.
Compounded GLP-1s prescription medications such as Semaglutide and Tirzepatide help regulate appetite, improve metabolism, and support long-term weight management. Paired with expert guidance by Dr. Ashe and ongoing support, this program is designed to help you achieve real, lasting results.
GLP-1 medications are injectable prescription medicine that may help adults and children aged ≥12 years with obesity (BMI ≥30 for adults, BMI ≥ 95th percentile for age and sex for children), or some adults with excess weight (BMI ≥27) (overweight) who also have weight-related medical problems to help them lose weight and keep it off.
Compound Semaglutide and Tirzepatide weight loss medication are the same weight loss drug as the brand equivalents (Ozempic, Wegovy and Zepbound, Mounjaro) at a fraction of the cost. In addition, compounded GLP-1s offer the opportunity to tailor the medication to individual needs and tolerances. Compounded GLP-1s, like the brand name counterparts, are extremely safe. These medications have been on the market since 2022 and have been studied since 2016. They are taken by millions of diabetics and obese people all over the world. In addition, they have been carefully evaluated in dozens of studies done in the US, South America, Europe and Japan. Other than mild to moderate GI side effects there are few side effects.
Semaglutide and Tirzepatide may be able to help you lose weight and keep it off. It is for adults with obesity or some adults with excess weight and weight-related medical problems. Along with a reduced calorie meal plan and increased physical activity, GLP-1s have proven results with weight loss.
On average, GLP-1s led to a 20% reduction in body weight after 12 weeks of intensive lifestyle change (Including diet and exercise).
On average, over 16 months, patients lost 15% of their total body weight, with the average weight loss of 35 lbs.
Average weight loss of 44 lbs. (19% of their body weight) on 10 mg dose.
Average weight loss of 48 lbs. (21% of their body weight) on 15 mg dose.
How do GLP-1s work?
Your brain gets signals from different places in your body. Some of these signals are appetite hormones that help regulate how much food you eat. GLP-1 injections target the areas of the brain that regulate your appetite and therefore food intake. These prescription medications work similarly to one of these natural appetite hormones, so you eat fewer calories, and lose weight. After injections, you might feel less hungry throughout the day and therefore eat less. It’s in a drug class called glucagon-like peptide 1 (GLP-1) agonists. Reducing appetite combined with increased exercise leads to weight loss.
Semaglutide and Tirzepatide (both the Compounded drugs from a compounding pharmacy or from the brand name versions) are derived from the GLP-1 hormone. After eating a meal, they begin a chain reaction by first increasing insulin and lowering glucagon (the hormone responsible for eating). The surge in insulin and reduction in glucagon has the effect of delaying gastric emptying which sends signals to the brain of fullness.
In addition, these medications work by binding to the GLP-1 receptors in the skeletal muscle, liver, and pancreas, and most importantly, in the brain appetite centers. This reduces cravings, especially for sweet and fatty foods. This helps the individual whose goal is to lose weight quickly and safely. It’s proven to be a powerful and long-lasting appetite suppressor without all of the complications of the stimulating older medications. In addition, the improvement in blood sugar makes GLP-1s a great choice for overweight diabetics. Weight loss has been shown even in the first month of use. The weight loss with compounded GLP-1s is the result of the following mechanisms:
1. Decrease appetite and craving
2. Increase in satiety and delayed gastric emptying
3. Changes in food preferences- away from fatty foods and carbohydrates
Losing weight with GLP-1s can also impact weight related conditions including improvements in blood pressure, cholesterol, and blood sugar.
BENEFITS OF GLP-1s:
● Improves blood sugar control
● Reduces body weight in obese or overweight adults
● Lowers blood glucose levels after meals
● Reduces appetite
● Slows gastric emptying and prolongs feelings of satiety
Both are prescription weight management medicine taken once weekly. After determining which medication is best for you, Dr. Ashe will start you on an FDA approved weight loss protocol and follow you throughout your weight loss journey. These medications are taken on a weekly basis with escalating doses each month. You will remain on the same dose for a 4 week time period. Every 4 weeks, your dose will be titrated up based on your weight loss goals and side effects. In some patients, the dose may not need to be titrated up based on weight loss goals or side effects. It’s important to follow the dosing schedule as recommended.
The most common side effects of GLP-s medications may include: nausea, diarrhea, vomiting, constipation, stomach (abdomen) pain, headache, tiredness (fatigue), upset stomach, dizziness, feeling bloated, belching, gas, stomach flu, heartburn, reflux, runny nose or sore throat.
Tips for managing nausea:
Nausea is a common side effect when first starting GLP-1 medication. If you experience nausea, be sure to contact your health care provider. Ways to manage it may include:
Eat bland, low-fat foods, like crackers, toast, and rice
Eating foods with high water content like soups or gelatin
Avoid lying down after you eat, which may predispose you to heartburn and reflux
Go outdoors for fresh air
Eat more slowly
Nausea: the most common side effect. It usually occurs during the first 1-2 days after the injection. It may be associated with some mild vomiting. Lowering the dose or delaying the escalation of the dose often solves this problem. More than 50% of patients have minimal to no nausea. Only about 25% of patients experience significant nausea. Zofran dissolvable tablets or Compazine suppositories are used.
Vomiting: usually, in the beginning, is often associated with skipping meals and then eating a large meal or eating too fast. You can take Zofran or Compazine.
Diarrhea: less common, usually intermittent, possible by changes in food or the effect of GLP-1s on the lining of the GI tract. Treat with Imodium, if persistent.
Constipation: very common and again intermittent, may or may not be related to medications, where there has been a significant reduction in food and especially in fats and oil. Treat with Miralax, and Metamucil capsules.
Heartburn: reflux is very common when taking these medications. It’s due to the delay in stomach emptying. Treatment with over the counter antiacids such as Rolaids or Tums or Omeprazole (Prilosec) daily in the morning) or Pepcid AC at any time, if needed.
Fatigue, lack of energy: this occurs when skipping meals normally but is significantly increased with these drugs which are designed to lower blood sugar in diabetics.
Important Safety Information:
❖ GLP-1s should not be used with other GLP-1-containing products or other GLP-1 receptor agonist medicines (including Mounjaro, Zepbound, Ozempic, Rybelsus, Trulicity, Victoza, Wegovy, Byetta-but this is not an all-inclusive list)
❖ It is not known if GLP-1s are safe and effective when taken with other prescription, over the counter, or herbal weight loss products
❖ It is not known if GLP-1s can be used safely in people with a history of pancreatitis
What is the most important information I should know about GLP-1s?
Both Semaglutide and Tirzepatide may cause serious side effects, including:
❖ Possible thyroid tumors, including cancer. Tell your healthcare provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath. These may be symptoms of thyroid cancer. In studies with rodents, GLP-1 medicines that work like it caused thyroid tumors, including thyroid cancer. It is not known if Semaglutide or Tirzepatide will cause thyroid tumors, or a type of thyroid cancer called medullary thyroid carcinoma (MTC) in humans.
Do not use Semaglutide or Tirzepatide if:
❖ you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
❖ you have had a serious allergic reaction to Semaglutide orTirzepatide or any of the ingredients in these medications.
❖ Before using Semaglutide or Tirzepatide, tell your healthcare provider if you have any other medical conditions, including if you:
❖ have or have had problems with your pancreas or kidneys
❖ have type 2 diabetes and a history of diabetic retinopathy
❖ have or have had depression, suicidal thoughts, or mental health issues
❖ are pregnant or plan to become pregnant. Semaglutide and Tirzepatide may harm your unborn baby. You should stop using Semaglutide or Tirzepatide 2 months before you plan to become pregnant
❖ are breastfeeding or plan to breastfeed. It is not known if Semaglutide or Tirzepatide passes into your breast milk
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Semaglutide and Tirzepatide may affect the way some medicines work, and some medicines may affect the way Semaglutide and Tirzepatide work. Tell your healthcare provider if you are taking other medicines to treat diabetes, including sulfonylureas or insulin. Semaglutide and Tirzepatide both slow stomach emptying and can affect medicines that need to pass through the stomach quickly.
What are the possible serious side effects of Semaglutide and Tirzepatide?
Semglutide and Tirzepatide may cause serious side effects, including:
❖ inflammation of your pancreas (pancreatitis). Stop using these medications and call your healthcare provider right away if you have severe pain in your stomach area (abdomen) that will not go away, with or without vomiting. You may feel the pain from your abdomen to your back
❖ gallbladder problems : GLP-1s may cause gallbladder problems, including gallstones. Some gallstones may need surgery. Call your healthcare provider if you have symptoms, such as pain in your upper stomach (abdomen), fever, yellowing of the skin or eyes (jaundice), or clay-colored stools
❖ increased risk of low blood sugar (hypoglycemia) in patients with type 2 diabetes, especially those who also take medicines for type 2 diabetes such as sulfonylureas (Ex. Glyburide, Glipizide, Glimepiride, Tolbutamide) or insulin. This can be both a serious and common side effect. Talk to your healthcare provider about how to recognize and treat low blood sugar and check your blood sugar before you start and while you take GLP-1s. Signs and symptoms of low blood sugar may include dizziness or light-headedness, blurred vision, anxiety, irritability or mood changes, sweating, slurred speech, hunger, confusion or drowsiness, shakiness, weakness, headache, fast heartbeat, or feeling jittery
❖ kidney problems (kidney failure). In people who have kidney problems, diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration), which may cause kidney problems to get worse. It is important for you to drink fluids to help reduce your chance of dehydration
❖ serious allergic reactions. Stop using Semaglutide or Tirzepatide and get medical help right away, if you have any symptoms of a serious allergic reaction, including swelling of your face, lips, tongue, or throat; problems breathing or swallowing; severe rash or itching; fainting or feeling dizzy; or very rapid heartbeat
❖ change in vision in people with type 2 diabetes. Tell your healthcare provider if you have changes in vision during treatment with GLP-1s.
❖ increased heart rate. GLP-1s can increase your heart rate while you are at rest. Tell your healthcare provider if you feel your heart racing or pounding in your chest and it lasts for several minutes
❖ depression or thoughts of suicide. You should pay attention to any mental changes, especially sudden changes in your mood, behaviors, thoughts, or feelings. Call your healthcare provider right away if you have any mental changes that are new, worse, or worry you.